An economic evaluation of resistance training and aerobic training versus balance and toning exercises in older adults with mild cognitive impairment

PLoS One. 2013 May 14;8(5):e63031. doi: 10.1371/journal.pone.0063031. Print 2013.


Background: Mild cognitive impairment (MCI) represents a critical window to intervene against dementia. Exercise training is a promising intervention strategy, but the efficiency (i.e., relationship of costs and consequences) of such types of training remains unknown. Thus, we estimated the incremental cost-effectiveness of resistance training or aerobic training compared with balance and tone exercises in terms of changes in executive cognitive function among senior women with probable MCI.

Methods: Economic evaluation conducted concurrently with a six-month three arm randomized controlled trial including eighty-six community dwelling women aged 70 to 80 years living in Vancouver, Canada. Participants received twice-weekly resistance training (n = 28), twice weekly aerobic training (n = 30) or twice-weekly balance and tone (control group) classes (n = 28) for 6 months. The primary outcome measure of the Exercise for Cognition and Everyday Living (EXCEL) study assessed executive cognitive function, a test of selective attention and conflict resolution (i.e., Stroop Test). We collected healthcare resource utilization costs over six months.

Results: Based on the bootstrapped estimates from our base case analysis, we found that both the aerobic training and resistance training interventions were less costly than twice weekly balance and tone classes. Compared with the balance and tone group, the resistance-training group had significantly improved performance on the Stroop Test (p = 0.04).

Conclusions: Resistance training and aerobic training result in health care cost saving and are more effective than balance and tone classes after only 6 months of intervention. Resistance training is a promising strategy to alter the trajectory of cognitive decline in seniors with MCI.

Trial registration: NCT00958867.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cognitive Dysfunction / economics*
  • Cognitive Dysfunction / physiopathology
  • Cognitive Dysfunction / therapy*
  • Cost-Benefit Analysis
  • Exercise*
  • Female
  • Health Care Costs / statistics & numerical data
  • Humans
  • Patient Compliance / statistics & numerical data
  • Postural Balance*
  • Residence Characteristics / statistics & numerical data
  • Resistance Training / economics*
  • Treatment Outcome

Associated data


Grant support

The Pacific Alzheimer’s Research Foundation provided funding for this study (to TLA). JCD is funded by a Michael Smith Foundation for Health Research Senior Graduate Studentship, a Canadian Institute for Health Research Canada Graduate Scholarship. TLA is funded by a Canada Research Chair in Physical Activity, Mobility, and Cognitive Neuroscience and a Michael Smith Foundation for Health Research Scholar Award. CAM is funded by a Canada Research Chair in Pharmaceutical Outcomes and a Michael Smith Foundation for Health Research Scholar Award. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.